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著者: Ayumi Kaneuji, Tanzo Sugimori, Toru Ichiseki, Kiyokazu Fukui, Eiji Takahashi, Tadami Matsumoto
雑誌名: J Bone Joint Surg Am. 2015 May 6;97(9):726-32. doi: 10.2106/JBJS.N.00667.
Abstract/Text
BACKGROUND: We investigated the rate of conversion to total hip arthroplasty by twenty years and radiographic findings at a minimum of twenty years after rotational acetabular osteotomy.
METHODS: Between June 1986 and August 1991, we performed 172 rotational acetabular osteotomies in 168 patients with acetabular dysplasia. Of those, ninety-three hips (ninety-one patients), including twenty-three hips with pre-osteoarthritis, twenty-nine with initial osteoarthritis, and forty-one with advanced osteoarthritis, had clinical and radiographic findings available. The mean age of the patients was 32.4 years (range, twelve to forty-nine years). The duration of follow-up was a mean of twenty-three years (range, twenty to twenty-seven years) for seventy-six hips, excluding hips that underwent conversion to total hip arthroplasty.
RESULTS: Conversion to total hip arthroplasty by twenty years after surgery was performed in one hip (4%) with pre-osteoarthritis, two hips (7%) with initial osteoarthritis, and fourteen hips (34%) with advanced osteoarthritis. The hips with advanced osteoarthritis had a significantly higher rate of conversion to total hip arthroplasty than hips in the other stages did (p = 0.0005). At the latest follow-up or at conversion to total hip arthroplasty, the disease stage had not progressed in seventeen hips (74%) with pre-osteoarthritis, nineteen (66%) with initial osteoarthritis, and twenty-six (63%) with advanced osteoarthritis.
CONCLUSIONS: The progression of osteoarthritis after rotational acetabular osteotomy was not detected for at least twenty years in most hips with either pre-osteoarthritis or initial osteoarthritis in this cohort. Rotational acetabular osteotomy may delay conversion to total hip arthroplasty in advanced osteoarthritis.
LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.
PMID 25948519 J Bone Joint Surg Am. 2015 May 6;97(9):726-32. doi: 10.2106/JBJS.N.00667.
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